State regulators say they are once again monitoring a chain of assisted living homes with facilities in Northeastern Wisconsin after two residents died and others were injured or got sick under the care of new management.

The state's regulating arm said the incidents, primarily at two facilities in Southeastern Wisconsin, make him question whether Senior Lifestyle Corp. is capable of keeping residents safe.

"I am very concerned about their ability to maintain compliance and keep people safe," said Otis Woods, administrator of the Department of Health Services Division of Quality Assurance.

Chicago-based Senior Lifestyle took over the chain of 11 facilities in July 2013 after Gannett Wisconsin Media reported seven residents died in two years under the watch of Chicago-based CRL Senior Living Communities. CRL has since dissolved.

Most of the facilities, including those in Northeastern Wisconsin, have had no problems since Senior Lifestyle took over management. But problems at Parkside Manor in Kenosha and Merrill Hills Manor in Waukesha prompted state regulators to take a closer look at the entire chain, Woods said.

The company has responded to the state's concerns by making leadership changes, reassessing residents' needs and providing "significant" staff training, executives said.

"Really, the heart of our company is to help people. When we are faced with problems, we don't spare any resources to correct those," said Senior Regional Director of Operations Dave Richey.

In December, the state warned the company it will shut down the Waukesha-based facility if the quality of care doesn't improve before May.

The warning came after regulators found a resident at the facility who had developed eight severe bed sores, some four inches in diameter, last fall, according to inspection records. A hospice nurse told regulators that facility staff took a "hands-off approach" and did not call him when the sores needed redressing.

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Lakeshore Manor in Oshkosh is one of 11 assisted living homes in Wisconsin operated by Chicago-based Senior Lifestyle Corporation.(Photo: File/Gannett Wisconsin Media)

The Waukesha center also experienced two outbreaks of Norovirus in March and May 2014. A total of 39 residents became sick during the first outbreak and 24 became sick during the second outbreak. Three residents were hospitalized. Norovirus, sometimes referred to as a stomach flu, is highly contagious and causes vomiting and diarrhea.

Regulators cited the facility for failing to follow an infection control program, including improper hand washing and allowing sick staff to return to work before being symptom free.

At the company's Kenosha business, the state prevented the facility from accepting new residents for several months in 2014 after two residents died. One woman, who required a diet of clear liquids, choked to death July 5 after a caregiver fed her fried chicken. Another resident died on June 22; regulators cited the facility for failing to follow doctors orders as that second resident's health declined.

The state has since lifted the admissions ban but found additional violations, including improper medication storage and failure to supervise residents, during a follow-up inspection. The report documents a resident who fell 10 times in two months last fall. The man suffered a head laceration and a broken collarbone.

"We are committed to understanding (the problems), and we have thoroughly investigated and implemented trainings and resources to provide the highest quality care," said company Vice President of Clinical Services Patricia Foran.

She said the violations at the Waukesha and Kenosha properties are not indicative of the care provided to residents at other facilities. The company owns and operates about 90 facilities in 23 states, making it one of the largest asssisted-living facility companies in the nation.

Overall, the company has performed well since coming to Wisconsin in 2013, but "I'm concerned they're beginning to slide in terms of compliance," said Woods, who serves as one of the state's administrative regulators.

The Gannett Wisconsin Media Investigative Team reported in December that 24 assisted living residents died in the state's 15 largest counties following mistakes or mistreatment by caregivers in 2012 and 2013. At least 94 other residents were hospitalized or treated in emergency rooms for broken bones, debilitating bed sores and other injuries or illnesses that might have been prevented.

The number of assisted living homes in Wisconsin has ballooned 54 percent in the past decade. The residents staying there have also become older and sicker. But, unlike nursing homes, assisted living facilities offer limited medical assistance and residents remain independent decision-makers.

—arodewal@gannett.com and follow him on Twitter @AdamGRodewald and on Facebook at Facebook.com/AdamGRodewald.